胸腔镜诊断的非特异性胸膜炎的远期随访分析
发布时间：2019-06-19 09:41
【摘要】：背景:胸腔镜是诊断不明原因胸腔积液的一项安全、有效的操作,但仍有一部分胸腔积液病人在做完胸腔镜后仍不能得到有效的诊断,这些病人的远期预后不明确,仍有恶性胸腔积液的可能性。方法:从2005年7月到2014年6月,833例胸腔积液患者于北京朝阳医院接受了胸腔镜检查,并取得了胸膜病理标本。我们对其中62例行胸腔镜后仍不能得到明确诊断的患者进行了为期两年的随访调查,将其中52例可得到完整临床及随访资料的患者纳入本研究。结果:本研究共纳入52例患者(男性31例,女性21例)。平均随访时间为35.5±40.9个月(1-143个月)。其中21(40.4%)例患者仍不能得到明确诊断,8(15.4%)例患者在之后的随访及检查中被诊断为恶性胸腔积液,23(44.2%)例患者被诊断为良性疾病所致胸腔积液。随访中发现,患者出现胸腔积液复发及胸腔镜下见到胸膜斑块或结节可能与恶性胸膜疾病相关。结论:对胸腔镜检查后仍不能得到明确诊断的患者(即非特异性胸膜炎患者)需进行密切随访,特别是有胸腔积液复发或胸腔镜下见到胸膜斑块或结节的患者更应警惕有无恶性胸腔积液可能。对于非特异性胸膜炎病人,进行为期1年的随访观察相对有效、经济。
[Abstract]:BACKGROUND: Video-assisted thoracoscopy is a safe and effective operation for the diagnosis of pleural effusion. However, a part of the patients with pleural effusion still cannot be diagnosed effectively after the thoracoscope. The long-term prognosis of these patients is not clear and the possibility of malignant pleural effusion is still present. Methods: From July 2005 to June 2014, the patients with pleural effusion were treated with video-assisted thoracoscopy in Beijing Hospital, and the pleural and pathological specimens were obtained. We conducted a two-year follow-up survey of 62 patients who were still not well-diagnosed after video-assisted thoracoscopy, and 52 of these patients received complete clinical and follow-up data were included in this study. Results:52 patients (31 males and 21 females) were included in the study. The mean follow-up time was 35.5 to 40.9 months (1-143 months). Of these,21 (40.4%) patients were still not well diagnosed,8 (15.4%) of patients were diagnosed with malignant pleural effusion in follow-up and examination, and 23 (44.2%) patients were diagnosed with pleural effusion due to benign disease. Follow-up revealed that patients with recurrent pleural effusions and the presence of pleural plaques or nodules under video-assisted thoracoscopic surgery may be associated with malignant pleural diseases. Conclusion: Patients (i.e., patients with non-specific pleurisy) who are still unable to get a clear diagnosis after thoracoscopic examination are required to follow-up, especially if there is a recurrence of pleural effusions or the patients who have seen the pleural plaque or nodule in the video-assisted thoracoscopic examination should be more aware of the possibility of malignant pleural effusion. For non-specific pleurisy patients, a 1-year follow-up observation was relatively effective and economical.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R561.1
，
本文编号：2502256
[Abstract]:BACKGROUND: Video-assisted thoracoscopy is a safe and effective operation for the diagnosis of pleural effusion. However, a part of the patients with pleural effusion still cannot be diagnosed effectively after the thoracoscope. The long-term prognosis of these patients is not clear and the possibility of malignant pleural effusion is still present. Methods: From July 2005 to June 2014, the patients with pleural effusion were treated with video-assisted thoracoscopy in Beijing Hospital, and the pleural and pathological specimens were obtained. We conducted a two-year follow-up survey of 62 patients who were still not well-diagnosed after video-assisted thoracoscopy, and 52 of these patients received complete clinical and follow-up data were included in this study. Results:52 patients (31 males and 21 females) were included in the study. The mean follow-up time was 35.5 to 40.9 months (1-143 months). Of these,21 (40.4%) patients were still not well diagnosed,8 (15.4%) of patients were diagnosed with malignant pleural effusion in follow-up and examination, and 23 (44.2%) patients were diagnosed with pleural effusion due to benign disease. Follow-up revealed that patients with recurrent pleural effusions and the presence of pleural plaques or nodules under video-assisted thoracoscopic surgery may be associated with malignant pleural diseases. Conclusion: Patients (i.e., patients with non-specific pleurisy) who are still unable to get a clear diagnosis after thoracoscopic examination are required to follow-up, especially if there is a recurrence of pleural effusions or the patients who have seen the pleural plaque or nodule in the video-assisted thoracoscopic examination should be more aware of the possibility of malignant pleural effusion. For non-specific pleurisy patients, a 1-year follow-up observation was relatively effective and economical.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R561.1
，
本文编号：2502256
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